Tech and Data Connection for a Healthier South Dakota
Grants for EHR adoption, health information exchange connections, cybersecurity and technology upgrades, plus a statewide rural health data platform.
RHTP state profile · South Dakota
South Dakota Rural Health Transformation Program
South Dakota received $189.5 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 38th of 50 states. The South Dakota Department of Health (DOH) runs the program with the Department of Social Services (DSS), funding ten initiatives across the state's 64 rural counties, from health technology and workforce to Medicaid payment models, behavioral health and EMS.
Year 1 awards, all 50 statesSD: $189.5M
Texas $281.3MNew Jersey $147.3M
$189.5MYear 1 award, 38th of 50
10Funded initiatives
64 / 66South Dakota counties are rural
DOHSouth Dakota Department of Health
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
South Dakota's program at a glance
The award is fixed for the year. Spending moves every quarter, so South Dakota's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Year 1 award$189,477,607, 38th of 50 states
Run bySouth Dakota Department of Health
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives10
Rural counties64 of 66
Spending data through July 31, 2026South Dakota's section of the Year One Report →Initiatives
What does South Dakota's RHTP fund?
South Dakota's RHTP funds ten initiatives under four focus areas: connecting technology and data, advancing the rural workforce, keeping health care local and strong, and transforming systems for sustainability. DOH runs most of them, DSS runs the Medicaid and behavioral health initiatives, and every funding opportunity maps to one of the ten.
Building a Sustainable Rural Healthcare Workforce
Recruitment incentives and education-based retention support for health workers who commit to five years of rural service.
Expand and Strengthen Rural Community Health Worker Workforce
Training, certification, Medicaid billing support and program development for community health workers and community health representatives.
Rural Health Forward: Training and Resource Hub
Online and in-person continuing education for rural frontline providers.
Medicaid Primary Accountable Care Transformation (PACT)
A phased Medicaid payment model that moves rural primary care practices from fee-for-service toward flexible, capitated payments that reward quality.
Medicaid Rural Health Access and Quality Grants
Competitive Rural Strong grants that help rural hospitals and clinics restructure services and stay financially viable.
Regional Maternal and Infant Health Hubs
Hub-and-spoke maternal care in rural and tribal areas, with care coordination for social needs and doula support.
Strengthening Chronic Disease Management
Rural chronic disease programs, self-management workshops, caregiver support, provider training and a Medicaid Health Home incentive pilot.
Integrated Behavioral Health through CCBHC and Collaborative Care
Rolls out the Certified Community Behavioral Health Clinic model statewide and expands collaborative behavioral health care in primary care.
Enhancing Sustainable Emergency Medical Services
Regional EMS hubs, better EMS data integration, telemedicine and EMS workforce support.
Recipients by initiative are in South Dakota's section of the RHTP Year One Report.
Source documents
South Dakota's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a South Dakota RFP.
PDFDOHSouth Dakota RHT Program Project NarrativeThe full plan, including all ten initiatives, the state's rural definition and its policy commitments.PDFDOHSouth Dakota RHT Program SummaryDOH's short overview of the plan's goals and four focus areas.PDFDOHSouth Dakota RHT Annual ReportThe state's first annual report to CMS, submitted August 31, 2026, with metrics and status for each initiative and policy commitment.PDFDOHSouth Dakota RHT Year 2 RoadmapQuarterly milestones for all ten initiatives from October 2026 to October 2027.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including South Dakota's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural county (64)Minnehaha and Pennington counties (2)
Eligibility
Which South Dakota counties are eligible for RHTP funding?
South Dakota's plan treats 64 of its 66 counties as rural, every county except Minnehaha (Sioux Falls) and Pennington (Rapid City), using the federal HRSA definition. Thirty-nine of those counties are frontier, with six or fewer residents per square mile, and the plan tracks the state's nine tribal nations separately. Providers in Minnehaha and Pennington counties can still take part, directly or as partners, when the work benefits rural South Dakotans, and each RFP states its own eligibility.
How to apply
How can South Dakota providers apply for RHTP funding?
South Dakota providers and vendors apply through requests for proposals from DOH and DSS, all posted on the state's Central Bidding site. Year 1 funds were obligated by October 30, 2026, and Year 2 rounds will post on the same site. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the ten. Submit a separate application for each initiative.
- Register on Central Bidding.Every RHT RFP posts on the South Dakota Central Bidding site, and registering there is how DOH sends RFP notifications.
- Register in SAM.gov.It isn't required to submit a proposal, but it is required before an award or contract is signed.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year.
- Ask DOH directly.Email DOH.info@state.sd.us or call (605) 773-3361, and check the RHT Resources and FAQs page first.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every South Dakota recipient.
Grants and contracts carry different obligations
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can South Dakota's RHTP funding pay for?
South Dakota's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to South Dakota's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $37.9M
Provider payments15% of award
About $28.4M
Administrative costs10% of award
About $18.9M
Rural Tech Catalyst Fund10% or $20M, whichever is less
About $18.9M
Replacing an existing EMR system5% of award
About $9.5M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to South Dakota's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
South Dakota's policy commitments carry deadlines
South Dakota committed to two policy actions in its application. One is done. CMS can reduce or recover funding if the other slips.
Physician assistant licensure compact
Join the PA Licensure Compact
HB 1146 signed March 9, 2026Presidential Fitness Test
Require schools to bring back the Presidential Fitness Test, in line with federal guidance
DOH plans to bring a bill to the 2027 legislative sessionSouth Dakota already belongs to the physician, nurse and EMS licensure compacts, and its plan also lists compacts for psychologists, social workers and counselors.
Years 2 to 5
$40B
Future awards depend on progress
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading South Dakota's spending data
Use the numbers in South Dakota's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as South Dakota reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search South Dakota's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major South Dakota announcements
Gov. Rhoden announces about $7.2 million in RHT grants for 25 EMS projects.
The state awards more than $13 million in 12 modernization and infrastructure grants to Certified Community Behavioral Health Clinics.
DSS submits a USDA waiver to exclude soft drinks from SNAP purchases, as required by House Bill 1056. The same day, DOH submits its first annual report to CMS.
The state and CMS announce $90 million in 82 technology and data grants for digital health modernization, cybersecurity and interoperability.
Gov. Rhoden awards $31.5 million in 28 Rural Strong grants to rural hospitals and clinics.
The state names its first program management contractors: North Star Solutions, Black Hills Special Services Cooperative and Business Concepts & Applications.
Gov. Rhoden signs House Bill 1146, making South Dakota the 23rd state to join the PA Licensure Compact.
The state releases its first round of seven RHT requests for proposals.
Gov. Rhoden signs House Bill 1044, the appropriation that lets the state spend its Year 1 RHT funding.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Jan 29, 2026House Bill 1044 appropriation signed
- Feb 25, 2026First round of RHT RFPs released
- Mar 9, 2026PA Licensure Compact bill signed
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Aug 31, 2026First annual report submitted to CMS
- Oct 30, 2026Deadline to obligate Year 1 funds; Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Aug 31, 2027Second annual report and Year 3 continuation due
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Rural Strong grants, $31.5 million to 28 projects in Year 1, are the main route for rural hospitals and clinics to restructure services. Technology and data grants drew the largest share of Year 1 money, $90 million across 82 grants. Watch the Central Bidding site for Year 2 rounds, which follow the Year 2 Roadmap.
For partners and vendors
South Dakota's program is provider-led: DOH is not taking technology or remote monitoring vendors directly under the technology initiative, so vendors work through participating providers and health systems. The state buys planning, project management and evaluation through RFPs, and contracts so far have gone to firms such as North Star Solutions, Black Hills Special Services Cooperative and Business Concepts & Applications.
For applicants and grantees
Build tracking for the metrics South Dakota reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed the state's annual rescoring. The next annual report to CMS is due August 31, 2027.
FAQ
South Dakota RHTP FAQs
Who runs South Dakota's Rural Health Transformation Program?
The South Dakota Department of Health (DOH) runs South Dakota's Rural Health Transformation Program, with the Department of Social Services (DSS) leading the Medicaid and behavioral health initiatives, using federal funding from the Centers for Medicare & Medicaid Services (CMS). DOH manages the state's plan, posts funding opportunities on the Central Bidding site and answers questions at DOH.info@state.sd.us. The program is South Dakota's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did South Dakota receive?
South Dakota received $189,477,607 for Year 1 of the Rural Health Transformation Program, 38th of 50 states. Every state got $100 million in baseline funding, and the rest of South Dakota's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on South Dakota's progress.
Can South Dakota RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of South Dakota's award each year, about $37.9 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can South Dakota providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to South Dakota's plan, up to 15% of the award each year, about $28.4 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how South Dakota is spending its RHTP funding?
The RHTP Year One Report tracks how much of South Dakota's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. Awards announced after July 31, such as $90 million in technology and data grants in August 2026 and the behavioral health and EMS grants that followed, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving South Dakota
These RHT Alliance members serve South Dakota providers, with support that spans virtual nursing, virtual care, remote monitoring, EHR and health data, diagnostics, patient education and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow South Dakota's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.